| Objective For investigating and camparing the effects of Nifediping GITS and Cilazapril on protective functions for endothelium in patients with essential hypertension(EH), patients with mild to moderate EH and healthy controls were studied. To detect the serum concentration of soluble ICAM-l(sICAM-l), interleukin-6(IL-6), endothelins(ET), nitric oxide(NO) , C-type natriuretic peptide(CNP) and peroxidative lipid in patients with essential hypertension to act as the markers of endothelial functions. First, we observe the changes of these markers in patiente with EH. Second, Patients with EH were randomly divided into two groups and treated with Nifedipine GITS and Cilazapril. The plasma levels of sICAM-1, IL-6, ET, NO, CNP and peroxidative lipid were compared before and after 4-weeks treatment. By analysising the changes of these observation markers of two groups, We evaluate the protective functions and decompression effects of these two drugs.Methods 96 patients with mild to moderate EH were randomly divided into two groups (A and B) and treated with Nifedipine GITS and Cilazapril. The patients of group A(n=48) were administrated with Nifedipine GITS PO, 30mg/d for 4 weeks and those of group B(n=48) were administrated with Cilazapril PO, 2.5 or 5mg/d for 4 weeks.40 heathy controls of similar age , sex , blood sugar and serum lipid were also studied. The plasma levels of siCAM-1, IL-6, ET, NO, CNP andperoxidative lipid were measured and compared before and after 4-weeks treatment.The serum concentration of sICAM-1 was measured by ELISA, the levels of ET, CNP and IL-6 were measured by radioimmunoassay,the levels of NO , malondialdehyde(MDA) content and the activity of superoxide dismutase (SOD) were measured respectively by nitrate reductase ,thiobarbituric acid(TBA) and xanthine oxidase methods.Results (1) In 96 patients with essential hypertension, comparing with the control group ,the serum concentration of sICAM-1 , IL-6 , ET and MDA content were significally increased (p < 0.05),while the level of NO , CNP and the activity of SOD were significally decreased (p < 0.05). Plasma levels of sICAM-1 , IL-6 , ET and MDA content were significally higher (p < 0.05) and the level of NO , CNP and the activity of SOD were significally lower in Grade II than those in Grade I(p < 0.05). (2) The Pearson correlation analysis showed : The levels of sICAM-1, IL-6, ET and MDA were positively related to the levels of SBP , DBP, MAP (p < 0.01) and the levels of NO,CNP and the activity of SOD were negatively related to the levels of SBP, DBP, MAP (p < 0.01) . (3) Plasma levels of sIC AM-1, IL-6,ET and MDA content were significally decreased (p < 0.05) and the levels of NO , CNP and the activity of SOD were significally increased at the end of 4-week treatment of Nifedipine GITS and Cilazapril (p < 0.05). (4) It is suggested that two antihypertensive drugs can significantly and safely decrease blood pressure .The decompression effect of Nifedipine GITS is 85.42% and that of Cilazapril is 81.25%. There are no difference between two drugs.Conclusions (1) Oxidate metabolism in patients with EH is more active and theactivity of endogenetic antioxidase is lower than that of normal persons. (2 ) The endothelium function of patients with EH has been impaired and there exits dysequilibrium of blood vessel diastole factors(NO , CNP) and contraction factors (ET)in patients with EH. (3 )In patients with EH, the expression of sICAM-1 and IL-6 are higher than that of normal persons in vessel endothelium and that two marks of inflammation contribute to arteria atherosclerosis. (4) Nifedipine GITS and Cilazapril can not only decrease blood pressure effectively but also inhibit leucocyte adhering, intensive the ability of antioxidizing and ameliorate the endothelial function so that they could protect endothelial function. (5) This experiment shows that Nifedipine GITS can protect vessel endothelial function similar to Cilazapril.
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